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Discussion in 'Physician Scientists' started by ProdigyMD, Apr 9, 2007.
I'm having a tough time figuring why not go to Baylor's MSTP?
Where else are you considering?
Baylor is a very good program as any MSTP surely is if they are receiving funding. The question is if the school fits you.
1. Do you like the curriculum (teaching, schedule, testing procedures)?
2. Do you have potential PIs in mind that you would like to work for (at least 3)?
3. Do you like Houston? Could you live there?
4. Are there other factors which affect location? (eg. family, significant other, etc).
I think the only big detractor about Baylor is that there is some instability with them switching teaching hospitals and building their own.
Also, a friend of mine that considered going there two years ago said that they have a history of longer PhDs (~5 years). This is could be seen as a benefit or a negative, depending... I think long vs. short has been argued many times in other threads.
i agree with the length thing. they don't seem to integrate the phd (rotations, classes) into the first 2 years so in ur 3rd year u're just starting rotations, so adding to the length.
Interesting point- however, I think it is misleading.
it must be added that at Baylor you will have access to training at the public hospital (BTGH), the VA, the private hospital (St. Luke's), and Texas Childrens, not to mention Methodist and MD Anderson for special electives. While it's true that certain departments will move to the new hospital, you will still train at all these institutions.
This is really one of the best aspects to training at Baylor- where else will you get that diversity?
I thought you get that kind of diversity at most places... off the top of my head, case western students can train at 3 (4?) different hospitals, univ. cincinnati students can train at 5-7 hospitals (VA, children's hospital, university hospital, christ (I think..), jewish (lol), and one more), dartmouth, university of washington.. hell, practically every school I interviewed at
seconded. Most places I visited had a variety of hospitals, public/private/govt/children's to choose from.
Not necessarily. Don't forget that you get 6 months of Clinics (as part of the second year) before you start the PhD, so when you finish the PhD it is possible to finish the MD in a single year.
This is true- although not reflective of the MSTP class, where there are no residency restrictions.
I guess things have changed in the last 7 years!
Might get a lot of heat for this, but I think it is very unwise to do 6 months of clinical rotations prior to starting the PhD. I still don't understand why programs do this as the disadvantages far outweigh the advantages in my mind. Maybe I would have a different opinion if my program was structured this way, but having gone through the whole process I think it is definitely a mistake. Also, you will get a diversity of training at almost any major medical school and the diversity of training (i.e. is there a VA? a county hospital?) is probably more of an important factor when choosing a residency than when choosing a medical school, IMO.
Also- let me say this about program length: While it's true that program curriculae may impact average times to graduation, the ultimate determinant of the MSTP training is on you. Having a reasonable PhD length is based on three basic factors:
1- picking a quality mentor who supports you
2- picking a quality project
3- hard work
If anyone wants a more thorough explanation of the above I will provide it. But if these conditions are favorable, you will have a PhD completed at ANY institution in a reasonable time.
Why do you think its a mistake?
I also have been through the whole process, and in my opinion it does not make one bit of difference. If anything, it only wets your appetite for clinical medicine and gets you thinking more globally during your PhD. Im may also serve to rule-in/rule-out certain residencies for some people.
I think the primary problem is simply logistics. I am not entirely sure how the program is structured, but from what is written here it sounds like once you come back from your PhD you do only one more year before graduating (2nd half of MS3 and MS4)? I wrote about this earlier in another thread, but trying to finish up required 3rd year clerkships (e.g. shelfs!), trying to narrow down a subspecialty choice by taking AIs/electives, and applying to residency programs/going on interviews (esp. if you are in competitive specialty and have to interview at tons of prelim and specialty programs) all in one year would simply be a huge nightmare (especially if your specialty is early match). If you already know what you want to do (e.g. Medicine) and you already did a rotation in medicine prior to your PhD, then that is all fine and well but what if you are unsure and need to do some electives to find out? Then there are annoying things like Step 2 CK/CS to get out of the way. Will program directors care that your clinical LORs are 5+ years old? It sounds like a miserable and hectic year, and in my opinion, the last thing you need before starting a brutal intern year.
Finally, I think it is very important that you do not discount the effect that 5 years off will have on your clinical skills (not that you have many to lose to begin with, but still). 5 years is a long long time. If you are trying to shine on an audition rotation right after you come back from the lab, it is simply going to be harder if you are competing with other 4th years who have just finished a whole year of MSIII and are clinically sharp. Not to say it can't be done, but it is a reality. I'm sure some MSTPers are clinical superstars who can remember after a 5 year layoff how to interpret a complicated ABG on rounds but if I was in that situation I would be lucky if I could remember what things I should add/subtract to figure out the anion gap.
Out of curiosity, is it possible for MD/PhD students at Baylor to either finish their entire M3 year before starting their PhDs, or else to begin research immediately after finishing classes in January of the M2 year? Of course, you'd have to take the USMLE earlier than everyone else if you did this (or else take it six months into your PhD). But your schedule is already "screwed up" compared to the MD-only schedule anyway, so I don't see why it shouldn't be allowed. I think if it were me, I would want to take it with the rest of my entering class (i.e., after six months in the lab). That way, you'll have a lot more control over your daily schedule, and you won't have to worry about classroom tests. Maybe it would be something that's worth looking into if nobody has asked before. Just thinking out loud here.
The program is not that rigidly structured. Students try to return to medical school around January, giving them a full two years of clinical experience and only 1.5 years of basic science. This is really better in many ways, as most students feel like much of the first two years of med school are worthless anyway. Because they have fewer requirements than regular med studets (there IS some integration between programs, BTW), they CAN finish all of med school in about one year if they return in April/May. But you have virtually no vacation time.
Regarding old LOR's, this is never really a problem. most MSTPs take medicine/surgery first, to get them out of the way. You have to do a Sub-I anyway, so if you are going into medicine your letter should come from your medicine Sub-I fourth year. You can always do more electives in that field if you feel like having fresh LORs.
Regarding clinical skills- they come back pretty quickly, and you are a much better med student the second time around, trust me.
That's cool then if you come back in January, sounds totally doable and reasonable. What is the primary reason for structuring it that way (6mo of clinic before PhD)? Every couple of years we have people in my program who insist on doing clinical rotations before choosing a lab, as in their mind they can't decide on what type of research they want to do unless they have some exposure to clinical medicine. I didn't have that problem and was raring to get in the lab after 2nd year. Personally I still rather prefer having all my clinical training stuck together in one big chunk (MS3/MS4, R1-3, then 1st year of fellowship) - there are enough transitions as is if you are going for a career as a physician scientist, one less transition between basic science and clinical medicine is appealing to me.
On the one hand I see your point, but isn't "transitioning" between being a Clinician and an Scientist what being one is all about?
Hey Q, that's a good point you make and I'd be curious if anyone has considered it.
You do start with the other graduate students, but you don't have to take all the coursework- you get exempt from courses you "transfer" from med school (like Neuro, Cell bio, others). You can also reduce the number of rotations if you know what lab you want to join (you just do reading rotations or something else). The qualifying exam is the same- as it should be.
Don't forget- you never had a summer break (you were essentially doing your MSIII year), so there really was no way to start earlier than other grad students.
I'm not certain there IS a point. many are really looking forward to the 6 months of clinics and putting some of their knowledge to use before going back to classes. On the other hand, I really don't think there is any detriment to it either. For some people, it helps them plan out their future career and use the spare time in their PhD accordingly.
I think the biggest problem I had with baylor was that you don't start doing rotations until after you're done with MS1 and MS2. What's worse than that (at least, this is what I understood, but I could be wrong since I don't go there) is that you have to choose a graduate program/department before you start doing rotations. It seems like other schools have it where you do rotations whereever you want and then choose the department based on the PI you end up working for.
Transitioning during training is painful if you ask me. The biggest downside for me is that your knowledge/skills inevitably atrophies when you are away from something, and you have to play catch up once you come back. I think this has a bigger impact in clinical medicine (i.e. if your clinical training is broken up) than it does in basic science, as clinical medicine is much more dependent on sheer volumes of knowledge in comparison to basic science (a gross generalization to be sure). Why throw in another transition when there really doesn't need to be one?
Even once you are an established Physician Scientist, in all likelihood you will try to minimize "transitioning" - e.g. you will have one day (or half-day) a week specifically designated as your clinic day where you focus solely on clinical medicine/seeing patients, or you will have a 2 week block of time where your function/focus is to be an inpatient attending. In my opinion it is hard to juggle two things at the same time, either patient care or your work in the lab is going to suffer if you are constantly running back and forth between the two. I'm sure some people are able to pull this off, but from what I've seen it is difficult (e.g. setting up a gel then getting a page for a stat consult when you only have half the wells loaded, or getting paged out in the middle of a lab meeting, a committee meeting, in the middle of making grant figures, etc). Protected research time free of clinical duties is key to success, IMO.